Intracytoplasmic Sperm Injection (ICSI)

Infertility Treatment with Intracytoplasmic Sperm Injection (ICSI): New Life India, New Delhi

We all know now that there could be many reasons or causes for your Infertility. One of them could be the male partner’s low count of sperm or their poor quality. In order to make the infertility treatment effective, Intracytoplasmic Sperm Injection, one of the techniques used in Assisted Reproductive Technology (ART), is considered to be very useful.

Sperm collection

First of all, effort is made to collect sperm by way of ejaculation via penis stimulation or copulation. If the sperm cannot be collected using ejaculation, a small incision surgically is used to remove them from the testicles. This method of sperm recovery is performed in case of a blockage preventing sperm from being ejaculated. The method is also used when there are problems in sperm development.

Why ICSI?

ICSI is performed for the following reasons.

When your partner’s sperm do not move to the egg at all;

They can move to the egg but can’t fertilize it;

This happens because:

Your partner has a low or nil sperm count;

Your partner has abnormally-shaped sperm. Because of their abnormal shape, they have poor motility. It means the sperm are unable to swim well.

In some cases, the male partner may have had an irreversible vasectomy or injury and unable to ejaculate sperm. Instead, they get collected in the testicles or the epididymis.

Similarly, sometimes because of diabetes or spinal cord injuries, the male partner has problems getting an erection and ejaculation.

If you have tried IVF you may move on to ICSI if not enough eggs could be retrieved, or if eggs retrieved for IVF were not successfully fertilized.

ICSI and all male fertility problems

All male fertility problems cannot be solved through ICSI. Genetic problems also play a crucial role before deciding on ICSI.

Genetic Testing

Genetic testing is performed on men in order to avoid possible genetic problems that could affect progenies. Experts in fertility treatment opine and recommend that men who have low sperm count or no sperms in their semen for reasons other than blockage should go in for genetic testing before they proceed with ICSI.

ICSI Procedure?

Similar to the standard IVF treatment, your ovaries are stimulated with fertility drugs to develop several mature eggs for fertilization. Once your eggs have become ready for collection, you and your spouse would have to go in for separate treatment procedures.

Your spouse is asked to give sperm sample on the same day by ejaculating in a bowl wherein your eggs are collected. In case of nil sperms in the semen, your treating doctors try extracting them surgically.

These procedures are called:

Percutaneous Epididymal Sperm Aspiration (PESA); OR (from Epididymis)

Testicular Sperm Aspiration (TESA)

In most of the cases, one of the above two surgical methods work well for removing or extracting enough sperm. In case of their failure, your doctors may take biopsy of testicular tissue that has embedded sperm. The procedure is called:

Testicular Sperm Extraction (TESE); OR

Micro-TESE, in case the surgery is performed with microscope

Sometimes, doctors carry out TESE before the beginning of treatment cycle by giving local anaesthesia. The extracted sperm are then frozen using cryopreservation technique. The discomfort of the surgery caused to your spouse is comforted with the help of painkillers.

An ultrasound on you helps the treating doctors to locate your eggs. These eggs are removed using a fine hollow needle, of course, by giving you local anaesthesia.

After this, the role of embryologist comes into play. He or she isolates individual sperm in the lab and injects them into each of your eggs. In about two days or so, your fertilised eggs become small balls of cells. They are embryos.

The following procedure is the same as of IVF. Your treating doctors will transplant one or two embryos with the help of catheter into your uterus through your cervix.

How many embryos should be transferred to your uterus is the moot question. It all depends on your overall health condition and age. If you are below 40, one or two embryos are transferred. Women above the age of 40 can have maximum of three embryos transferred if the doctors are using her own eggs. If the donor’s eggs are being used, two is the right number. On the alert side, extra embryos are frozen for use if the ongoing cycle is not successful.

Embryos may be transferred two to three days after fertilization, or five days after fertilization. Five days after fertilization the embryo will be at the blastocyst stage. If you’re just having one embryo transferred (called elective single embryo transfer, or eSET), having a blastocyst transfer can improve your chances of a successful, healthy, single baby.
Hey, Congratulations! An embryo will get attached to your uterus wall. That is your growing baby. After about two weeks, you may undergo pregnancy test.

Duration of ICSI treatment?

One cycle of ICSI between four to six weeks:

You and your spouse will have to spend a complete day at the clinic to carry out egg and sperm retrieval procedures.

You will be asked to come back to the clinic later between two days and six days later to undergo embryo transfer procedure.

Success Rate of ICSI:

Much higher than the IVF method;

However, much will depend on the type of fertility problem and age. The younger you are, the better will be your success rate!